New story in Science and Health from Time: Gilead Prices Coronavirus Drug Remdesivir at $2,340 for Rich Countries Gilead Prices Coronavirus Drug Remdesivir at $2,340 for Rich Countries

The maker of a drug shown to shorten recovery time for severely ill COVID-19 patients says it will charge $2,340 for a typical treatment course for people covered by government health programs in the United States and other developed countries.

Gilead Sciences announced the price Monday for remdesivir, and said the price would be $3,120 for patients with private insurance. The amount that patients pay out of pocket depends on insurance, income and other factors.

“We’re in uncharted territory with pricing a new medicine, a novel medicine, in a pandemic,” Gilead’s chief executive, Dan O’Day, told The Associated Press.

“We believe that we had to really deviate from the normal circumstances” and price the drug to ensure wide access rather than based solely on value to patients, he said.

However, the price was swiftly criticized; a consumer group called it “an outrage” because of the amount taxpayers invested toward its development.

The treatment courses that the company has donated to the U.S. and other countries will run out in about a week, and the prices will apply to the drug after that, O’Day said.

In the U.S., federal health officials have allocated the limited supply to states, but that agreement with Gilead will end after September. They said Monday that the government has secured more than 500,000 additional courses that Gilead will produce starting in July to supply to hospitals through September.

“We should have sufficient supply … but we have to make sure it’s in the right place at the right time,” O’Day said

In 127 poor or middle-income countries, Gilead is allowing generic makers to supply the drug; two countries are doing that for around $600 per treatment course.

Remdesivir’s price has been highly anticipated since it became the first medicine to show benefit in the pandemic, which has killed more than half a million people globally in six months.

The drug interferes with the coronavirus’s ability to copy its genetic material. In a U.S. government-led study, remdesivir shortened recovery time by 31% — 11 days on average versus 15 days for those given just usual care. It had not improved survival according to preliminary results after two weeks of followup; results after four weeks are expected soon.

The Institute for Clinical and Economic Review, a nonprofit group that analyzes drug prices, said remdesivir would be cost-effective in a range of $4,580 to $5,080 if it saved lives. But recent news that a cheap steroid called dexamethasone improves survival means remdesivir should be priced between $2,520 and $2,800.

“This is a high price for a drug that has not been shown to reduce mortality,” Dr. Steven Nissen of the Cleveland Clinic said in an email. “Given the serious nature of the pandemic, I would prefer that the government take over production and distribute the drug for free. It was developed using significant taxpayer funding.”

Peter Maybarduk, a lawyer at the consumer group Public Citizen, called the price “an outrage.”

“This is a drug that received at least $70 million in public funding” toward its development, he said. “Remdesivir should be in the public domain.”

Gilead says it will have spent $1 billion on developing and making the drug by the end of this year.

The drug is has emergency use authorization in the U.S. and Gilead has applied for full approval.

New story in Science and Health from Time: U.K. Researchers Say Have Found First Drug that Improves COVID-19 Survival U.K. Researchers Say Have Found First Drug that Improves COVID-19 Survival

Researchers in England say they have the first evidence that a drug can improve COVID-19 survival: A steroid called dexamethasone reduced deaths by up to one third in severely ill hospitalized patients.

Results were announced Tuesday and researchers said they would publish them soon. The study is a large, strict test that randomly assigned 2,104 patients to get the drug and compared them with 4,321 patients getting only usual care.

The drug was given either orally or through an IV. It reduced deaths by 35% in patients who needed treatment with breathing machines and by 20% in those only needing supplemental oxygen. It did not appear to help less ill patients.

“This is an extremely welcome result,” one study leader, Peter Horby of the University of Oxford, said in a statement. “The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become standard of care in these patients. Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide.”

This is the same study that earlier this month showed the malaria drug hydroxychloroquine was not working against the coronavirus. The study enrolled more than 11,000 patients in England, Scotland, Wales and Northern Ireland who were given either standard of care or that plus one of several treatments: the HIV combo drug lopinavir-ritonavir, the antibiotic azithromycin; the steroid dexamethasone, the anti-inflammatory drug tocilizumab, or plasma from people who have recovered from COVID-19 that contains antibodies to fight the virus.

Research is continuing on the other treatments. The research is funded by government health agencies in the United Kingdom and private donors including the Bill and Melinda Gates Foundation.

New story in Science and Health from Time: ‘Superforecasters’ Are Making Eerily Accurate Predictions About COVID-19. Our Leaders Could Learn From Their Approach ‘Superforecasters’ Are Making Eerily Accurate Predictions About COVID-19. Our Leaders Could Learn From Their Approach

When Dr. Anthony Facui said in late May that there’s a “good chance” a COVID-19 vaccine will be ready by the end of this year, Steve Roth badly wanted to believe him. Roth, a 74-year-old New Yorker who endured fever, pneumonia and anxiety while fighting the virus, wants life to go back to normal as much as anyone. And he respects Fauci, the longtime head of the National Institute of Allergy and Infectious Diseases (NIAID), ”an awful lot,” he says. But he just doesn’t think Facui’s timeline is realistic. Instead, he’s putting his proverbial money on mid 2021.

“Like everybody else, I’d like to see a vaccine today,” says Roth. “But what’s the real world?”

Roth is a semi-retired market researcher, not a biostatistician or epidemiologist, and hardly seems to be the kind of person you’d go to for insight into vaccine production. But in his spare time, Roth moonlights as a “superforecaster”— a member of a team of ordinary people who make surprisingly accurate predictions for the forecasting firm Good Judgement, Inc. In recent months, businesses, governments and other institutions have worked with superforecasters like Roth to help them understand how the COVID-19 outbreak might unfold.

That a group of semi-professional forecasters would somehow have accurate insight into anything as complex and important as the coronavirus pandemic sounds like the stuff of science fiction, or even ancient history—like the seers of old who told fortunes to kings and nobles. But the team behind Good Judgement, Inc. and the organization it spun off from (the research initiative Good Judgement Project) say they have established a rigorous system for identifying talented forecasters and sharpening their abilities. The company’s superforecasters undergo years of testing before they’re brought onto the team—in the early days, through tournaments sponsored by the Intelligence Advanced Research Projects Activity, and now on the open-to-the-public forecasting site Good Judgement Open. Under the current model, the best forecasters on Good Judgement Open are invited to an online community of superforecasters, where they can share ideas and contribute their predictions to a system that aggregates their forecasts. Good Judgement’s clients pay for answers to questions that are important to decision-makers; the superforecasters collect a share of the revenue. (Other prediction services, including Metaculus, use similar models, although like Good Judgement Open, Metaculus’ community is open to anyone; Metaculus also weighs all users’ input, giving more weight to better forecasters.)

Open Judgement’s superforecaster team has a track record of success, having made accurate predictions about world events like the approval of the United Kingdom’s Brexit vote in 2020, Saudi Arabia’s decision to partially take its national gas company public in 2019, and the status of Russia’s food embargo against some European countries also in 2019. Lately, they’ve taken their talents to the epidemiology world—in early February, Good Judgement’s team predicted there would be between 100,000 and 200,000 COVID-19 cases reported by March 20; the world hit the 200,000 mark one day earlier.

Unlike history’s prophets, forecasters like Roth do not claim to possess supernatural abilities. Instead, they say their accuracy is a result of using specific techniques to structure their thinking and constantly trying to improve their skills. Superforecasters also tend to share certain personality traits, including humility, reflectiveness and comfort with numbers. These characteristics might mean that they’re better at putting their ego aside, and are willing to change their minds when challenged with new data or ideas.

It’s unlikely that superforecasters like Roth could ever fully replace subject-matter experts. Michael Jackson, an associate scientific investigator at Kaiser Permanente Washington Health Research Institute, cautions that superforecasters are a “black box,” meaning their less-than-scientific methods make it impossible to vet their work in the same way that a scientist’s output would undergo peer review. And Philip Tetlock, a professor at the University of Pennsylvania and a co-founder of Good Judgement, acknowledges that there are times in which expertise is crucial (for example, he notes that some public health experts warned about the possibility of a coronavirus pandemic early in the outbreak.)

However, Tetlock argues that superforecasters have skills that experts may not: for example, they may also be more flexible than traditional scientists, because they’re not bound to a particular discipline or approach. Their predictions incorporate research and hard data, but also news reports and gut feelings. That way of working may increase their overall accuracy, says Tetlock. “Talented amateurs who pay attention to both the science and the news seem to be better at putting accurate probabilities on key outcomes in this phase of the crisis,” he says. “The experts were really good at warning us about the fundamental danger, but they may be less adept at adapting nimbly to the dynamics about this phase of the crisis.”

Superforecasters aren’t just smart, Tetlock says; they also tend to be actively open-minded and curious. They’re in “perpetual beta” mode, as he puts it in his book on the topic, Superforecasting: The Art and Science of Prediction— always striving to update their beliefs and improve themselves. Bryan Hartman, a 36-year-old computer science teacher in Illinois and superforecaster of six years, says that kind of flexibility can improve their predictions.

“[Superforecasters] provide a lot of counter information, which is called ‘red-teaming,’” says Bryan Hartman. “It’s not in a way to press anyone’s buttons. It’s always to make everyone see the whole picture … it’s very collaborative, and very few people take anything personally. We’re just trying to see if we can get it right.”

Superforecasters are particularly good at predicting how people’s choices will affect future outcomes, says Good Judgement Inc. vice president Marc Koehler. That kind of insight that could be particularly helpful during an event like the COVID-19 pandemic, given that people’s adherence to measures like social distancing and mask-wearing can have dramatic effects down the road.

“If you’re wondering how a virus rips through a herd, an epidemiologist is going to give you the best answers about whether it mutates and stuff like that,” says Koehler. “But when the herd turns into human beings who make decisions to comply or not comply with different guidelines, and when governments set policies about stay home or not at home, or keep schools open or not, when all of those different factors get involved, that’s where a group of human forecasters really excels.”

Jackson agrees that it’s possible superforecasters could better predict or accommodate for events like mass protests compared to typical viral modeling approaches. “The challenge is that what’s going to happen in the future isn’t just based on the properties of the virus itself,” he says. “It’s very much driven by human behaviors, and we’ve seen that those can change abruptly and unpredictably even in just the short course of this pandemic so far.”

Furthermore, superforecasters can assist experts in sounding the alarm early in a major crisis—which, in the case of COVID-19, can save lives. Shannon Gifford, a 61-year-old who has been forecasting for more than eight years and is the deputy chief projects officer for the Denver, Colorado mayor’s office, says her colleagues were taken aback when she nudged them as early as January to consider how COVID-19 could affect the city.

“I remember saying in large meetings, ‘Well, whatever’s happening in a couple months could be very different if this virus crashes the economy,’” says Gifford. “And people [were] looking at me blankly, like, ‘You’ve got to be kidding. What are you talking about?’

Gifford says that she wasn’t surprised that people in Denver and elsewhere underestimated the threat of COVID-19, calling it “human nature.”

“Part of it was we simply had no idea, at that point, how much spread had already taken place,” she says. “Because we had so little testing. And I think a lot of people were lulled into inaction believing we didn’t have much of a problem here, when we almost certainly did.”

Officials calling the shots, like mayors and governors, might be skeptical of the entire forecasting enterprise. But even if they ignore the superforecasters’ predictions, they could learn something from their methods. A willingness to change your mind when presented with new information, contend with your biases, challenge one another’s ideas, and break down problems into specific questions are all desirable qualities in people who make big, important decisions. “It’s the combination of thinking about what will happen, and why it will happen, that can be very useful to making decisions,” says Roth.

New story in Science and Health from Time: Clean Energy Capacity Grew at a Record Pace in 2019, U.N. Report Finds. But it Needs to Grow Even Faster Clean Energy Capacity Grew at a Record Pace in 2019, U.N. Report Finds. But it Needs to Grow Even Faster

The world’s renewable power capacity grew at a faster rate last year than ever before, while the cost of adding new capacity fell to a record low, says a U.N. Environment Program report released June 10.

Researchers found that in 2019, governments and companies created 184 gigawatts (GW) of new renewable power capacity —12% more than was added in 2018. That increase came despite investment in the sector rising by just 1%, to $282.2 billion, meaning clean power capacity was cheaper to create per watt. (The report does not include the older technology of large hydropower damns because such projects are not subject to the same market dynamics as newer renewable sources, and their long development-time scales make investments hard to measure precisely.)

Renewable energy, like wind and solar power, is becoming cheaper thanks to improving technology, growing economies of scale, and fierce competition in the sector. For example, in the second half of 2019, it cost 83% less to generate electricity from solar plants than it did 10 years earlier, according to the report.

Generating more electricity from renewable sources—which, unlike fossil fuels, do not emit greenhouse gasses like carbon dioxide that trap heat in the Earth’s atmosphere—is essential to preventing the worst effects of climate change. Currently 13.4% of global electricity is generated from renewable sources. That’s up from 12.4% in 2018 and 5.9% in 2009, according to the U.N.

However, to keep on track to meet the goal set by the 2015 Paris agreement, of keeping average global temperatures from rising more than 2°C over preindustrial levels, we would need to add some 3,000 GW of new non-hydro renewable energy capacity by 2030, according to the report. So far countries and corporations have committed to adding just 826 GW of new non-hydro renewable power capacity, likely costing $1 trillion, by 2030, the report finds.

The report’s authors write that they hope the “lack of ambition” for future investment would be rectified as governments lay out recovery packages to deal with the economic impact of the COVID-19 pandemic.

Since the pandemic began, climate campaigners have been pushing for economic packages to avoid propping up the fossil fuel industry, which has slumped as global energy demand has fallen. Instead, many want government funds and loans to be directed towards clean energy and low-carbon industries. Officials in both the E.U. and China, as well as leaders at the International Monetary Fund and the World Bank, have promised to make fighting climate change central to their plans. In the U.S., though, President Donald Trump has pledged extra support for the oil and gas industry.

“The slump in the fossil fuel sector due to COVID-19, combined with the resilience clean energy has shown during this period, made it clear that clean energy is a smart investment,” the reports’ authors argue. “If governments take advantage of the ever-falling price tag of renewables to put clean energy at the heart of COVID-19 economic recovery….they can take a big step towards clean energy and a healthy natural world.”

New story in Science and Health from Time: COVID-19 Is a Symptom of a Bigger Problem: Our Planet’s Ailing Health COVID-19 Is a Symptom of a Bigger Problem: Our Planet’s Ailing Health

The COVID-19 outbreak is a global tragedy. Hundreds of thousands have died, healthcare systems are buckling, and the future is uncertain for millions of people whose livelihoods are collapsing. It is absolutely right that the focus today is on saving lives here and now. In the same spirit of doing what we can to safeguard people’s wellbeing, we must not content ourselves with containing the acute crisis. We must also look ahead to what we can learn from this crisis to prevent future risks. COVID-19 is a reminder of how vulnerable even our modern, technologically advanced societies are.

The biggest lesson is that COVID-19 is more than an illness. It is a symptom of the ailing health of our planet. Humanity’s dysfunctional relationship with nature has caused this wider disease. Understanding this root cause is critical, if we want to rise stronger after the crisis. COVID-19 is a zoonotic virus—meaning it spilled over from wild animals to humans—and evolved into a pandemic due to the now well-established risk cocktail of the 21st century: ecosystem destruction, species loss, global warming, colliding with risky human behavior like illegal wildlife trade. All of this has played out in a globalized network of trade and travel.

COVID-19 is not an isolated event. Research shows that 60% of all known infectious diseases in humans and 75% of all emerging infectious diseases are zoonotic. As we move into natural habitats, and exploit ever more wildlife, contact between humans and disease-carrying species increases.

Zoonotic diseases aren’t the only symptom of poor planetary health. Climate change is an even more serious crisis; it potentially poses existential risks for future generations, and is already having real-time impact on millions globally, for example through extreme weather events such as cyclones and floods. Changes in climate have a multiplier effect, leading to other problems, from ecosystem stability to food production and human conflict. Ecosystem and biodiversity loss are threatening the planet’s ability to provide goods and services –deforestation for example, disrupts our weather patterns and the water cycle, contributes to climate change, and destroys the habitats of important species. Chemicals and waste are polluting the air, soil and water, killing millions each year.

All of these symptoms make clear that the planet’s health, and therefore our health, is deteriorating rapidly. And nature, just like a human, can only take so much before things reach the point of collapse.

We have known for a long time that we face a climate crisis and an ecological crisis. And now we are in the midst of another crisis, a tightly interconnected pandemic. It is not enough to focus only on economic recovery. Building resilience based on a whole-system approach is fundamental. This means the protection and sustainable management of our global commons—such as our atmosphere and the earth’s rich diversity of plant and animal species—must be center-stage of priority-setting in our societies.

This year was meant to be a “super year for nature,”—the world was due to agree on a global plan to protect and restore biodiversity beyond 2020. The next global climate meeting was scheduled to take place in Glasgow, with natural solutions to climate change a key issue for discussion and countries expected to propose new commitments to lower their emissions, in line with the Paris Agreement. The international community was also due to set out a framework for better management of chemicals and waste.

COVID-19 has made it crystal clear that we must deliver on these agendas. They are the means to form a blueprint for an economic and societal future that factors nature into everything we plan and build, from homes to cities to food systems.

But we cannot effectively address common global concerns, such as the environment, individually. The spread of this virus has proven once and for all that, in this globalized world, there are no local problems—pollution and pathogens know no borders. Faced with the multifaceted impacts of COVID-19, multilateralism has to evolve. Governments, businesses, the UN, international organizations, scientists and individual citizens need to unite as a single global community to safeguard people from avoidable risks.

After COVID-19, nothing will be the same. But life can be better. We have had a moment to think and reflect. Perhaps we don’t need as much stuff as we thought we did. Perhaps we can fill our lives with closer relationships, with moments, with creativity. Perhaps we recognize what really counts in our lives: being safe and being free. When we overcome COVID-19, we should not risk what we have won. We should do what we can to stabilize our environment, our support system. We need to think about how we can restore nature by living life differently.

One thing is clear. We cannot just develop a vaccine for COVID-19, call it “job done” and rev the economic engines back into the red. We need to use the reboot to incentivize sustainable innovation and green investment. The credits and subsidies that many governments are handing out so generously in this moment are not just a necessity—they are also a chance to direct economic progress towards sustainable development. This is an important insurance policy to avoid future pandemics.

To stabilize the climate, we have the Paris Agreement on keeping global temperature from rising more than 2°C above pre-industrial levels. This translates into reducing greenhouse gas emissions to net zero by 2050. For biodiversity and ecosystem stability, we need a similar binding target to halt the loss of biodiversity. Of course, setting targets alone does not do the job. Governments must work hard to achieve them. However, we have an important window right now, thanks to the bailout programs and financial stimulus packages arising from the COVID-19 crisis. Coupling science-based targets on climate and nature with these recovery mechanisms is a key strategy we need to deploy now, to win twice: we build resilience against future shocks and we create healthier economies. Because investing in sustainability is not something we do for nature or for the climate. We do it for us.

New story in Science and Health from Time: The U.K. Records Its Sunniest Spring Ever Amid Worrying Climate Change Trends The U.K. Records Its Sunniest Spring Ever Amid Worrying Climate Change Trends

The U.K. has recorded its sunniest spring, with May being its sunniest calendar month, since records began over 90 years ago, according to data published by the Met Office—the U.K.’s national weather service—on June 1. For many people in the U.K, it has meant long days of soaking up the sun as lockdown restrictions eased from May 13. However, experts say that this record, along with other extreme weather trends globally appears to be consistent with what they expect from climate change.

There were more than 626 hours of sunshine between March 1 and June 1, surpassing the previous record of 555.3 hours in 1948, the Met Office said. In comparison, Italy’s capital city Rome, a popular holiday destination for Britons, sees an average of 621 hours in the spring and in the Turkish city, Istanbul – 548 hours. The U.K. usually gets about 440 hours each spring and only 10 years have had more than 500 hours of sunshine. According to Liz Bentley, Chief Executive of the Royal Meteorological Society, a leading independent expert on climate and the weather, there have only been three U.K. summers that have been sunnier.

These weather patterns are the result of jet streams — a strong core of winds around 5 to 7 miles above the earth’s surface — being directed north and around the U.K., according to Mark McCarthy, the head of the Met Office’s National Climate Information Centre. “But we don’t quite understand why these statistics have been so extreme. And we can’t say that this how it will be from now on. Jet streams might behave differently. Compared to other countries in Europe, we get a lot of variability on our weather,” he adds.

Weather patterns have also created relatively dry conditions as the U.K. saw its driest May in 124 years, with less than 10 millimeters rain falling across England on average. Northamptonshire – a region located near the center of England – has been the driest county so far, recording only 1.5mm of rain during May.

The U.K’s sunny spring came off the back of an extremely wet winter. The Met Office recorded the U.K’s wettest February on record, with 237% the average rainfall for February, boosted by Storms Ciara and Dennis, which brought heavy rains to the whole of the country.

The U.K. has never seen such large differences in rainfall amounts from the wet winter to the dry spring in its national rainfall series that dates back to 1862. “Records like these are being broken on a much more frequent basis as our winters get warmer and wetter and our summers get hotter and drier,” she says.

“The concern around this comes from an indication of a longer term trend around climate change and the issues this may have related to potential droughts, agriculture, biodiversity and more,” says James Ford, Professor and Priestley Chair in Climate Adaptation at the U.K’s University of Leeds.

McCarthy of the Met Office says, “In isolation, we can’t say this [sunny spring] is about climate change. I expect it will trigger more research and analysis. But we know our climate is changing.” Average global temperatures have risen by more than 1°C since the 1880s and two-thirds of the warming has happened since 1975. And 19 of the 20 warmest years all have occurred since 2001 (with the exception of 1998). “The fact is we’re seeing extremes being broken globally and when we put this together it’s likely to be consistent with what we expect by climate change – we expect extremes to become more common, including more heat extremes, more droughts,” says Ford.